Much speculation filled the news about Zika virus over the past year. We watched as news filtered out from Brazil and other countries about the increasing incidence of microcephaly in newborn babies from mothers who were infection with the virus. And, as fears mounted, we witnessed its arrival in the US.
What is Zika?
Zika virus is a flavivirus caused by the bite of a Aedes mosquito. Symptoms generally include fever, skin rash, conjunctivitis, malaise, headache, muscle pain, and arthralgias. It typically lasts between 2-7 days. More concerning is that this virus has been linked with microcephaly in newborns and Guillaine-Barre syndrome. There is no specific treatment for this disease.
A short history
This virus was first discovered in 1947 by scientists researching yellow fever in Uganda. At that time, a monkey in the Zika (meaning “overcrowded”) Forest became sick with fever. The virus was isolated from this monkey but it wasn’t until 1952 that the first human was found to be infected in Nigeria. In 2007, the first major outbreak occurred outside of Africa in Micronesia on the Island of Yap.
In May 2015, a major outbreak occurred in Brazil, marking the first time it was witnessed in South America. Over the remainder of 2015, cases appeared in Hondoras, Cabe Verde, Columbia, Mexico, Panama, El Salvador, Guatemala, Paraguay, French Guinea, Martinque, and Puerto Rico. In November 2015, the Brazilian government became alarmed about the rising cases of microcephaly they were seeing and started suspecting that Zika may be the cause.
Zika virus news in 2016:
January 12, 2016: The CDC detected the virus in the brains of babies born with microcephaly, providing the evidence between Zika virus and microcephaly.
January 15, 2016: Canada and the US issue warnings for pregnant women not to travel to infected areas.
January 22, 2016: El Salvador issues a call for women not to get pregnant until 2018. Brazil also reported increasing incidence of cases of Guilliane Barre syndrome.
January 29, 2016: The World Health Organization (WHO) held an emergency meeting in Geneva to discuss the threat level.
February 1, 2016: Because of the connection between Zika and microcephaly, the WHO declares a global Public Health emergency.
February 2, 2016: The US reports a case of Zika virus being sexually transmitted in Texas. Venezuela reports a increase in the number of cases of Guilliane Barre syndrome.
February 4, 2016: Brazil reports a case of Zika being transmitted through a blood transfusion.
February 5, 2016: The CDC reports Zika actively being transmitted in 30 countries, mostly in the Americas.
February 8, 2016: President Obama requests $1.8 billion to fight the Zika virus.
February 17, 2016: Brazil confirms over 500 cases of microcephaly are attributable to Zika virus. The WHO contributes $56 million to fight Zika.
February 27, 2016: France reports a case of sexually transmitted Zika.
March 3, 2016: The Lancet publishes a case report of a 15 year old girl who developed acute myelitis from Zika virus.
March 8. 2016: The WHO issues a travel advisory advising women to avoid travel to Zika infected areas and confirmed that sexually transmitted disease is relatively common.
March 10, 2016: Cuba reports its first case of Zika.
March 21, 2016: South Korea reports his first case of Zika.
March 31, 2016: The WHO issues a statement that there is strong scientific evidence that links Zika virus with microcephaly as well as Guillian Barre syndrome.
April 2, 2016: Columbian authorities report their first case of Zika related microcephaly.
April 5, 2016: Viet Nam reports its first 2 cases of locally acquired Zika virus infection.
April 13, 2016: After extensive study, the CDC confirms that Zika virus can cause microcephaly.
April 15, 2016: The CDC reports the first case of male to male sexual transmission of Zika virus.
May 18, 2016: The first case of congenital microcephaly associated with Zika virus is reported.
May 20, 2016: The Institiut Pasteur in Cabo Verde performs sequencing of the Zika virus and confirms that it is the same circulating in the Americas and most likely originated in Brazil.
May 28, 2016: The WHO issues guidelines regarding the Olympic games in Brazil and stated that canceling or changing the location would not alter the international spread of the virus.
June 3, 2016: Emerging evidence reveals that other brain anomalies may be caused by the virus.
June 17, 2016: The WHO/PAHO and partners revise their strategic plan to place a greater emphasis on preventing Zika and managing its complications. The WHO asked for funds to implement this plan.
June 20, 2016: The United Kingdom reports its first locally transmitted Zika virus. France reports the first case of congenital syndrome in French Guinea.
July 15, 2016: The CDC reports the first case of female to male sexual transmission of the virus, which is the first time transmission from female to male has been observed. They advised against unprotected sex for the duration of the pregnancy.
July 26, 2016: Inovia and Geneone start trials for a vaccine.
July 29, 2016: Zika virus is detected in Florida in Miami-Dade and Broward counties.
July 2016: The WHO publishes target characteristics for an optimal Zika vaccine.
August 1, 2016: The CDC issues a travel warning for pregnant women traveling to the Wynwood neighborhood, in Miami, which is the first time the CDC issued such a warning against travel in the continental US due to a disease outbreak.
August 2, 2016: The WHO releases educational videos intended for those responding to the virus.
Mid-August 2016: Brazil and a few other countries start using new tools approved by the WHO, including genetically modified mosquitoes and surveillance traps.
August 25, 2016: At least 30 organizations are now working to develop a vaccine.
End of August 2016: More than 56 diagnostic tests have been developed for the detection of the virus.
August 26, 2016: The WHO issues guidelines on the diagnosis and management of Guiliiiane Barre syndrome associated with Zika virus.
August 30, 2016: The WHO issues guidance on managing pregnant women who may have been exposed.
September 15, 2016: The Lancet published an article showing the results of a case control study revealing a strong association between microcephaly and laboratory confirmed Zika virus.
September 16, 2016: The WHO issues guidelines on the prevention of sexually transmitted Zika virus.
October 14, 2016: The WHO includes Zika congenital syndrome on its fact sheet. This syndrome includes malformations of the head, seizures, dysphagia, hearing and sight abnormalities.
October 25. 2016: The WHO organization starts the Zika Virus Research Agenda.
October 26, 2016: The WHO issues its first quarterly update on its Zika response initiative.
November 18. 2016: The WHO declares the end of the public health emergency.
The above list is not inclusive of all the countries that have been infected with Zika: as of this date, 58 countries have had the active virus in their countries. These are all cases that were acquired by local transmission in those countries. While we learned much over 2016 about this virus, there is still a long journey ahead. No treatment yet exists and while many are scrambling to develop a safe, effective vaccine, we still do not have one. Additionally, controversy surrounds some of the proposed tools to eliminate this virus, such as genetically altered mosquitoes.
Despite the fact that the virus causes mostly relatively mild symptoms, babies are being born with devastating genetic malformations. If we are to prevent decades of suffering from these consequences, we need to find a solution now. Every day we delay, is another baby suffering the ravages of this disease.
About the Author
Linda Girgis MD, FAAFP is a family physician practicing in South River, New Jersey. She was voted one of the top 5 healthcare bloggers in 2016. Follow her on twitter @DrLindaMD.